There are significant losses of proteins in wound exudate. As there is no significant difference in the concentration of total protein between wound type, the rate of loss may be calculated as 2.9 g/dL times the volume of wound exudate. The rate of protein loss from wounds is similar to the presently assumed insensible loss rate of 12-25 g/d.

Introduction The purpose of this project is to enhance burn education, both inside and outside the Burn Center. The project was motivated by a perceived gap in burn education for the city’s Fire Department (FD). Here, we describe the progress made in closing this gap. In a combined effort between both institutions, a partnership has been developed to help new paramedic firefighters and existing firefighters understand the burn-care process and improve patient outcomes. Since its inception in August 2018, the Burn Strong Initiative has had 3 focuses: 1) train burn center personnel; 2) train FD personnel; and 3) conduct further community outreach. Methods Aim 1 – Burn Center Staff Training. To improve our clinical skills and to enhance our ability to serve as educators in the community, we committed to achieving Advanced Burn Life Support (ABLS) certification for > 90% of our Burn Center clinical staff. Aim 2 – Firefighter Training. The city requested that we develop and implement a new 2-hour Thermal Injury Update class delivered weekly for a total of 36 weeks to EMTs and paramedics, starting January 2018 thru December 2019. Aim 3 – FD Medical Staff Training. The city requested that the Burn Center provide an ABLS course for the FD’s physician staff. Results Aim 1 – To date, we trained 104 Burn Center staff in ABLS, 22 of whom became ABLS instructors. Aim 2 – Burn Strong has completed 28 Thermal Injury Update classes for 615 FD paramedics. There are 10 classes remaining through the end of this year. Total paramedics to be trained is expected to be > 1000. The paramedics receiving 2 CEUs for this course. Aim 3 – We trained 19 FD physicians in ABLS, 4 of whom have become ABLS instructors. We trained an additional 15 personnel at our Regional Advisory Council conference. Conclusions This training effort has better prepared us to treat these complex patients, and has become the initial point of entry into an immersive partnership between the burn center and the city FD. Training firefighters requires ongoing commitment and an understanding of the pre-hospital environment. We plan to continue and expand our partnership with the city and the region to improve burn care. Applicability of Research to Practice This project demonstrates how burn center personnel, through training tailored to local requirements, can collaborate with their FD, improve burn care, and build strong partnerships.